Pioneering heart valve procedure provides options for active patients

Pioneering heart valve procedure provides options for active patients, improving their quality of life and removing the need for Warfarin and further operations.

London Pioneers

The first ever implantations of new heart valve were performed in St Thomas’ Hospital, Kings College Hospital and Harefield Hospital earlier this month.Leading cardiac surgeons from London have joined forces to pioneer the use of the new INSPIRIS Aortic Tissue valve. This new valve has the potential to change the treatment paradigm for aortic stenosis patients globally.

“This development is particularly fantastic for patients who previously were restricted to living a lifetime on Warfarin. Now they can continue their lives as they once lived it before they developed valve disease as this new valve will allow them to be free of the restrictions that warfarin can place on them.” Mr Michael Sabetai, Consultant Surgeon at St Thomas Hospital.

Professor Olaf Wendler of Kings College Hospital says, ‘This new valve has been shown in tests to last much longer than even the gold standard valves we use today. For this reason, we are very excited, we can now treat the active heart valve patient and help them regain the quality of life they are so desperate to maintain.’

“This innovation has the potential to positively change the heart valve replacement landscape for the active patients. The new valve is designed to offer younger, more active patients an alternative to traditional mechanical valves, that doesn’t necessitate life-long anticoagulation using warfarin. The longevity of this resilient valve is intended to reduce the chance of patients needing additional operations in later years and could allow patients to regain their active lifestyles, have children and go back to active work.” said Adrian Carrol of Edwards Lifesciences, the innovators of this new technology.

After also implanting the Inspiris valve, Mr Toufan Bahrami, leading London Cardiothoracic Surgeon from Harefield Hospital summarises by saying, ‘This new valve is ideal for the younger, or active patients who would have previously had a mechanical valve.’ He also says, ‘Any patient that doesn’t want or couldn’t tolerate warfarin would be an ideal candidate for this new pioneering heart valve. The cost of using a mechanical valve can also be large. With Warfarin you can get delayed discharge of 3 to 4 days, putting additional pressure on long term patient care and all the costs surrounding that.”

According to the leading heart valve charity, Heart Valve Voice, ‘Approximately one and a half million people over the age of 65 across the UK are affected by heart valve disease. This number will increase as the UK population ages.

Aortic Stenosis is most common in people over the age of 50, many of whom are active and want to remain so. In a healthy aortic valve, the valve opens and closes to allow blood to flow through and around the body. When an aortic valve is narrowed (stenosis) blood can no longer flow unrestricted throughout the body. This can lead to breathlessness, dizziness when being active, tiredness and sometimes chest pains.

Aortic stenosis can be treated by heart surgery where the diseased valve is replaced with a ‘tissue’ or ‘mechanical’ valve. With limited treatment options for younger active patients’, mechanical valves and a life time of warfarin treatment seemed to be the favored treatment plan. This no longer has to be the case.

First Patient Stories

Mr Michael Sabetai, Consultant Surgeon at St Thomas Hospital describes his patient Peter as an active 60-year-old who spent all his working life as a scientist. He was diagnosed with acute heart failure due to severe aortic stenosis. Being very active in his daily life the 12 to 15-year lifespan of a conventional valve replacement was not an option for Peter as he did not want to have further surgery in his seventies. He was presented with this new heart valve option which meant there was no need for blood thinning medicine to be taken. Peter underwent the surgery at St. Thomas’ Hospital and recovered well and is now back on track with his active lifestyle. Before, Peter would have had a mechanical valve and a life on Warfarin.

Nosheen Khan, 27 years old, from Croydon, South London, is one of the first people in the world to have the new type of biotissue valve, fitted by renowned surgeon Professor Olaf Wendler, who works at King’s College Hospital in London. Nosheen had a faulty heart valve from childhood which was regularly monitored.

Prof Wendler said: ‘Although we have been replacing aortic valves for many years, this new device is a game-changer for patients who do not want to take blood thinning medication, especially women hoping to start a family. This means fewer operations, the possibility of a healthy pregnancy and a good quality of life for patients like Nosheen.’

Mr Toufan Bahrami, Harefield Hospital Consultant Cardiac Surgeon

American Heart Association: Warfarin prevents and treats serious medical problems caused by blood clots. This includes people who have had a mechanical heart replacement or suffer from an irregular heart rhythm called atrial fibrillation. Patients on Warfarin need to make very regular visits to their GP to get their blood checked. The major complications associated with Warfarin are clotting due to under dosing or bleeding due to excessive anticoagulation. The most serious bleeding is gastrointestinal or intracerebral. Excessive bleeding can occur in any area of the body, and patients taking Warfarin should report any falls or accidents. Active people need to take extra care.

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